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"Sometimes creativity just means the daily work of helping others to see a problem in a different way."

——Joseph L. Badaracco, John Shad Professor of Business Ethics at Harvard Business School



By the end of this chapter, you should be able to:

  • List muscles that are prime movers in common activities of daily living (ADL);

  • Name muscle groups that function to position and move the upper extremity in specific functional activities;

  • Identify prehension patterns of the hand used during common daily activities;

  • Present a systematic model for activity analysis;

  • Perform your own analysis of ADL activities.



Sam has treated Nathaniel for the past month to rehabilitate an elbow injury that was sustained when Nathaniel was working in interior remodeling and new construction. Nathaniel is now ready to return to work, but before he does, Sam is meeting Nathaniel at his work site this afternoon to assess his job and performance requirements. Sam wants to make sure that he has properly prepared Nathaniel to return to work to perform his job skills safely and effectively.


Every day, human beings carry out simple and complex movements involved in activities of daily living, activities involved in taking care of themselves, performing work related tasks, and enjoying leisure or recreation activities. Every individual carries out these tasks in a unique manner unto themselves; therefore, there is high variability in the way muscles are recruited and used during similar activities. For example, you may get out of bed in the morning differently than your brother or sister, and your routine of getting dressed and ready for school may be different than your roommate's or friend's routine. Before a clinician is able to assist a patient in adapting activities to overcome movement disorders, an understanding of normal movement must first be achieved. For this reason, the examples provided within the chapter assume normal movement. The descriptions of movement included in this chapter do not include all muscles involved in the tasks but only the major contributing muscles. The activities described within this chapter are organized in a proximal to distal direction, citing examples that utilize mostly shoulder movement first, then moving on to activities that require more elbow movement, and finally, activities that require more movement of the hand and fingers are discussed.


Functional applications in this chapter include only those activities and muscles of the upper extremity. If a person is standing while performing the upper extremity activity, then muscles of the lower extremity are also involved in the task, as are the trunk muscles. To prevent this chapter from becoming unwieldy in its content, however, focus will remain only on functions of the upper limb. It would be, of course, impossible to include all activities of the upper extremity ...

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